healthcare, mental health

High priced help for the hungry…

For some reason, my post about Adam and Darla Barrows’ love story has attracted a lot of attention. I am intrigued, because it’s somewhat uncommon for items in newspapers to generate interest for so long. Usually, you get a burst of interest in the hours or days after something hits, then people move on to the next thing. And I am especially surprised by the interest in my comments on Barrows’ piece, which was a Modern Love story, rather than a hard news item. I’m just an American blogger in Germany. Why do people care what I think? Why do they care so much that they want to respond or even set me straight? And do they know that sometimes their comments lead me on unexpected paths? That’s what today’s post is about– my unexpected trip into high priced help for the hungry in Switzerland. I never thought my post about a newspaper story would lead me there.

I recently got comments from two people who have never posted here before, both of whom have direct experience of loving someone with anorexia nervosa. One commenter seemed to agree with my take on Adam Barrows’ New York Times article about how he fell in love with a woman with anorexia. The other one clearly did not agree with me, and in fact, says my views are “outdated”. Both commenters have children who have suffered from anorexia. I appreciated that they took the time to read and comment. I won’t be surprised if others also comment, since that post is clearly very hot even a month after I wrote it. Adam Barrows’ story obviously really resonated with and rattled a lot of people.

I just want to mention a few things about that post. First off, all of my posts on this blog are mainly just my opinions. I share them with the world, but I don’t necessarily expect people to agree with me, nor do I assume I’m always right. I wouldn’t want everyone to agree, because it’s hard to learn anything new if everyone thinks the same way. Secondly, I really think that Barrows’ story was less about anorexia and its treatment, than the development of Adam’s unique love relationship with his wife. I think a lot of people read Adam’s story and got very triggered by it and felt the need to judge him. He probably knew people would have strong reactions to the story. Ultimately, I think a lot of people missed the point entirely, and focused on anorexia rather than the love story and his perspective as a man who loves someone with an eating disorder. Furthermore, Barrows’ story is not a long piece and was probably edited a lot, so it’s not a good representation of Adam Barrows’ character. It pained me to read so many nasty comments about Mr. Barrows, and that was why I wrote about his NYT piece in the first place. Finally, I’m really glad he wrote that story and shared it, despite the polarized reactions. It has really made me think and, as you can see, continues to inspire new posts for my blog. 😉

Which brings me to today’s fresh topic. One of the people who commented on my post expressed disappointment that The New York Times shared Barrows’ piece and “glamorized” anorexia. Looking on my Statcounter results, it appeared that “Danielle” might have been writing to me from England. If she is from England, it would make sense that she would give me hell about my comments. She may or may not be aware of how different the US and UK healthcare systems are. In the United Kingdom, citizens have access to the National Health Service, which means healthcare doesn’t cost people as much as it does in the United States. A basic level of affordable care is available to everyone.

In the United States, healthcare is very expensive for most people, even for those with decent health insurance, which is also expensive on its own. Mental health care coverage is often woefully inadequate. It’s been years since I last had a “civilian” health insurance policy, but I seem to remember that my coverage only allowed for thirty days of inpatient psychiatric treatment per year. And that’s if there were no pre-existing conditions! Outpatient care was somewhat more generous, but it was not covered the same way or to the same extent a physical problem would be.

In the United Kingdom, there is also a process called “sectioning”, in which people can be involuntarily hospitalized for mental health conditions. The Mental Health Act of 1983 allows for family members and physicians to act in another person’s best interests when it’s clear that they need psychiatric help and won’t cooperate on their own. Anyone who is being sectioned must be assessed by health care providers first, but it appears that a person can be sectioned for a much broader array of reasons than they can be in the United States. Someone who is starving to the point of death because they have anorexia nervosa could possibly be sectioned, for instance, even if they are over 18 years old.

In the United States, we do have the means for hospitalizing people against their will for psychiatric reasons, but it’s a lot more difficult to force an adult into psychiatric hospitalization than it is a child. A lot depends on the laws of specific states. Moreover, in the United States, involuntary commitment seems to be done most often in cases in which a person is clearly a danger to other people as well as themselves, and is not in touch with basic reality. Someone with anorexia nervosa is probably not going to pose a genuine threat to anyone other than themselves. They also tend to be basically rational in things besides their body image. Anyone who is curious about how eating disorders in the United States are treated may want to watch the excellent 2006 documentary, Thin, by Lauren Greenfield. As you’ll find out if you watch this film, a person’s insurance coverage is also quite important in their ability to access care. I can’t say that adult people with eating disorders never get forced into treatment in the United States, but I think it’s more difficult to do it there than it is in England and Wales.

In the 1960s, there was a big push in the United States to deinstitutionalize people with mental illnesses, which meant that a lot of facilities closed down, for better or worse. The emphasis is more on outpatient treatment. In fact, healthcare is more for outpatient treatment for regular medical conditions, too, mainly because of how bloody expensive it is.

An eye-opener about how eating disorders are treated in America.

As I was thinking about Danielle’s comment and chatting a bit with my friend, Alexis, who is herself employed in healthcare, I got to wondering how eating disorders are treated in Germany. I went Googling, and found a few items that didn’t tell me much. But then my eyes landed on an ad for a rehab in Switzerland– specifically, Paracelsus Recovery in Zurich.

I know Switzerland has really excellent medical care. I also know that it’s an eye-wateringly expensive place. I know healthcare is not cheap in Switzerland, either. I was interested to find out what this place in Zurich was like. I found out that it’s a family run business. Clients are treated one at a time, and have the option of staying in one of two huge penthouses.

The fees include five star treatment, to include a personal chef and a counselor who stays with the client 24/7 in beautifully appointed accommodations. There’s a medical staff, including nurse practitioners and physicians, a wellness staff, with personal trainers and yoga instructors, and therapists. If you access their Web site, you can take a tour of the posh penthouse, which includes a bedroom for the therapist. If you like, you can pay separately for accommodations at a hotel, although the accommodations are included in the price of the treatment and I’m not sure if you get a price break for staying off site.

A very comfortable place to recover in Zurich.

This center treats several different psychiatric conditions, including drug addictions, eating disorders, mood disorders, alcoholism, and behavioral addictions (porn addiction or gambling, for instance). It’s a very discreet place and, judging by the fees they charge, is intended for helping only the very wealthy. At this writing, it costs 80,000 Swiss Francs per person per week to be treated at this facility. To put this price into perspective, at this writing, 80,000 Swiss Francs is equal to about $86,000 or roughly 72,000 euros. The fees cover everything related to the treatment, although if you fall and break your arm or get sick with COVID-19 and need hospitalization, you will have to pay for that medical treatment separately. Also not included is accommodation for anyone who accompanies you or a two day pre-assessment, which is an additional 20,000 francs.

As I was reading about this place, it occurred to me that there must be a market for it. I’m sure their clients are mostly extremely wealthy people, such as royalty from the Middle East, Hollywood movie stars, rock stars, or business moguls from Wall Street. Paracelsus gets excellent reviews online, but I wonder how many people have had the opportunity to experience this kind of treatment. Still, it’s fascinating to read up on it. I wonder what it would be like to work at such a place. I’m sure they deal with some extremely high maintenance people. I also wonder what would prompt someone to start such a practice, which seems to cater only to extremely wealthy people. To be sure, that population is unique and may need special accommodations, but I’m sure the cases are uniquely challenging, too. People with a lot of money are often used to hearing the word “yes” a lot. Maybe such posh surroundings are less effective for people with addictions. But again, I could be wrong. At the very least, it looks like a very competently run place, and in a city well known for psychiatric care.

Wow… very beautiful and very expensive! And no need for a translator.

I found another rehab in Switzerland, Clinic Les Alpes, that has a relatively bargain basement cost of 45,000 Swiss Francs per week, although the typical stay is for 28 days, so you do the math!. It looks like there, you can be treated for exhaustion or burnout or addictions. They seem to focus on addictions the most and offer care that emphasizes comfort, as well as the classic 12 step program to sobriety. It’s in a beautiful area, just off the shores of Lake Geneva, in an area with many forests and no sound pollution (which sounds wonderful to me). But this program appears to be a lot less private. There are 27 rooms for clients to stay in rather than two exclusive penthouses.

I would imagine that healthcare in Switzerland there is delivered expertly, especially if one is paying many thousands of Francs. My experiences in Switzerland have mainly been in a few hotels, a couple of which were high end. The Swiss definitely do high end hotels right, although on the whole, I find it a rather boring, soulless place, even if it is also very beautiful and scenic.

Well… I’ll never darken the door at one of those very special rehabs in Switzerland. I do find them interesting to read about, though. They’re not for ordinary people with big problems. They are for extraordinary people with big wallets. Obviously, there’s a need and a market for them, since at least two of them exist… and to think I found out about them because of a comment on my post about a Modern Love story I read in The New York Times over a month ago! I am always amazed by what inspires me to think and to write… and that’s why I like to hear from people. I’m sure Danielle never knew her comment about how wrong my opinions are would lead me to research luxury rehabs in Switzerland. You learn something new every day!

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poor judgment, psychology, teen help

Repost: How a Facebook chat convinced me to get VPN access…

Here’s a repost from my original blog. I wrote it in February 2019, about a week before I felt the need to shut down access to that blog because I was being stalked. As I sit here this morning, thinking about what I’d like to write about, I realize that this post was a pretty good one, especially in the wake of Paris Hilton’s revelations about Provo Canyon School. I like to transfer some of the better content from my original blog to this blog when I can. Despite what my stalker and her friends think about me, some of the stuff I write is useful to others. I think this post is one of the useful ones.

As I write this, my husband is probably taxiing to the gate at the Frankfurt Airport.  He’s been gone all week, and I’ve been filling my time with whatever I can.  I watched movies, including Small Sacrifices, which killed about three hours, The Ryan White StoryRight to Kill, and Catherine: An Anorexic’s Tale.  I also watched the premiere episode of Glee, which aired when we lived in Germany the first time.

I was able to watch Glee and The Ryan White Story because I decided to purchase access to a VPN, and that gave me access to American Netflix.  I decided to get the VPN because I’m tired of dealing with geographical restrictions on news stories.  I like to keep up with what’s going on at home.  Unfortunately, the paper I grew up reading, Daily Press, is behind in complying with the privacy laws of Europe.  Consequently, whenever I want to read something on their Web site, I get a message that the content isn’t available in my location.

I used to have a VPN account.  I got it when we first moved back to Stuttgart in 2014, mainly so I could watch Netflix.  But then Netflix started cracking down on VPNs and German Netflix was offering some pretty good shows, anyway.  I cancelled the VPN and mostly didn’t miss it.  What prompted me to get a new account with a different company was a conversation I had on Facebook.

A couple of days ago, I wrote a post about all of the made for TV movies I’ve been watching this week.  One movie I watched was called Without Consent.  It starred a young Jennie Garth, and was about a privately owned psychiatric hospital for teenagers that basically abused them for insurance money.  I mentioned in my post that this was a big issue in the late 1980s and early 90s.  Psych care for “troubled teens” was a very big business in those days.  It probably still is, but I will admit that I don’t follow that issue as much as I used to.

One of my friends mentioned that she had spent time in one of those facilities.  I got the impression that maybe my description of the movie, Without Consent, had offended her.  I had intended the post to be kind of silly and fun, but you never know how you’ll come across, particularly to people who are sensitive to an issue.

Anyway, as we were chatting, I mentioned Charter Colonial Institute, which was a private psychiatric hospital in Newport News, Virginia.  I grew up not far from Newport News, and I knew of a few of my peers who went there.  It always had kind of a mystique about it.  Sometimes, when I worked at Busch Gardens in James City County, Virginia, I’d take a route to work that caused me to pass that hospital.  I knew its tree lined campus was secure, located very close to Warwick Boulevard and the river.  Charter was such a ubiquitous company in those days; young people would simply speak of “going to Charter” and people would know what they were talking about.

A vintage ad for one of Charter’s many private psychiatric hospitals.  Charter Colonial Institute aired similar ones in my area back in the 80s.

Several years later, Charter’s burgeoning business began to falter.  The hospital changed hands and it was known as Colonial Hospital for a few years.  Then Colonial Hospital went away… and for the past few years, that same “secure” building has been known as Newport News Behavioral Health Center, which is a privately run facility.  I was curious to learn more about what was going on there, so I started searching.  I ran across a couple of news articles from the Daily Press.  Of course, they were blocked in Germany, so I used the cell access on my iPad to start reading, which makes it look like I’m in New York.  But then I ran out of free articles…

I found some news about a young woman named Raven Nichole Keffer.  She was seventeen years old last June, when she arrived in Newport News for treatment for an addiction to heroin.  Born in Montgomery County, Virginia back in 2001, and in the custody of rural Giles County, she had recently spent time in Arlington, Virginia getting treatment for her drug problems before she was sent to Newport News.  For at least a week, she’d complained of feeling sick, but the staff evidently ignored her symptoms and complaints.  Keffer had trouble walking, breathing, and eating.  She even vomited blood at one point.  Still, for some reason, the staff at the center did nothing for her, and she apparently languished for just over a week before someone finally did something.  It came out later that some staff members felt Raven was drug seeking, and that’s why they didn’t call for help.  

On June 29th, 2018, Keffer collapsed at Newport News Behavioral Health Center.  An ambulance was called, and Keffer was taken to Bon Secours Mary Immaculate Hospital in Newport News.  It was there that she died a few hours later, officially at 10:33pm.  A staff member at the center mentioned to one of the first responders who had picked up Raven that she’d been sick all week and nothing had been done for her.

After I read about Raven in the Daily Press, I found a more detailed account on WAVY TV 10’s Web site.  That site was also blocked for me in Europe, but thanks to the VPN, I was able to hear her family members speak on video about what had happened.  To add insult to injury, Raven’s body was cremated about ten days after she’d died.  Her family was notified after the fact.

In October of 2018, investigators determined that staff members at Newport News Behavioral Health Center violated 13 state regulations in Raven Keffer’s case.  From the beginning, it appears that her even being at the center was inappropriate.  Raven Keffer had been recently hospitalized before she was admitted to the Newport News Behavioral Health Center and, according to its own admissions guidelines, Keffer should not have been admitted there.  The center’s admissions policy states that it doesn’t “accept patients who are addicted to drugs and need medical care for detoxing”.

Officially, Raven Keffer died of natural causes stemming from complications from lymphocytic adrenalitis, an auto-immune disorder that affects glands that produce adrenaline.  But she also had a serious heroin addiction that had required her to seek hospital care just prior to her admission to the center in Newport News.  Discharge instructions from the hospital where she’d been on June 13th indicated that she would need a follow up visit and perhaps surgery.  However, it’s clear that no one in Newport News did anything to arrange follow up care for Raven.  Her initial admissions paperwork was never even completed; there were several items left blank.

Video surveillance footage shows Raven being helped to see a nurse practitioner.  She had a registered nurse and a fellow patient supporting her, since she couldn’t walk unaided.  Once they reached the nurse practitioner’s office, the nurse walked away, leaving Raven to lean on the patient.  The nurse later left the unit and the other patient was shown on video dragging Raven across the room on a comforter.

In the wake of this fiasco, there’s been re-training at the center.  The nurse who abandoned Raven has been fired.  However, in November of 2018, the Newport News Behavioral Health Center was in the news again.  This time, it was because Child Protective Services in Newport News reported that a juvenile male at the facility was assaulted by a staff member.  The employee allegedly “punched the patient about the face, pushed him, and grabbed him”.  Other staff members tried to intervene and the patient was treated for injuries.  CPS noted that he had bruises on his face and marks on his neck and on an arm.

According to the news articles I’ve read, Paul Kirkham is the CEO of Newport News Behavioral Health Center.  I’m sure that his job isn’t easy, as teenagers in trouble are not an easy population.  However, if I were him, I’d be sweating bullets.  It really appears that extreme negligence is a problem at his facility.

Managed care is one reason why private psychiatric hospitals have gone down the tubes.  In the 80s, psychiatric medications were not as good as they are today.  Nowadays, many people who would have been hospitalized years ago can be treated outpatient.  You have to be pretty sick to wind up in a hospital, for any reason.  Managed care also pays less for fewer days.  But Charter’s woes also came about due to a public relations situation.  In 1999, an unflattering news report was aired regarding Charter’s business practices.  Terrance Johnson had a master’s degree in social work, but he took a job as a mental health technician.  While he was on the job, he wore a tiny camera, which recorded everything going on as he worked at his $8.35 per hour position.  People were paying thousands of dollars a day for “treatment”, but they were being watched over by “big guys”.  Really, being “big” was the number one qualification for the job.  Johnson’s size was more of a prerequisite for being a mental health technician than his MSW was.

I’m not sure if what Terrance Johnson encountered at a Charter hospital is still how these kinds of facilities are run.  I have read a few horror stories.  But it does sound like at least at one former Charter hospital, it’s business as usual.  My heart goes out to Raven Keffer’s family and anyone else who has suffered at one of these places.  And now that I have a VPN, I can read all about it.

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